Active NPI
Adam J Martin, MD
- Anesthesiology Physician
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4301506762
- Practice address
- 621 S New Ballas Rd Ste 3005B
Saint Louis, MO 63141-8266 - Phone
- (314) 251-7069
- NPI assigned
- Jun 29, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2017022178 | MO | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | 4301506762 | MI | Primary |
Addresses
Primary practice location
621 S New Ballas Rd Ste 3005B
Saint Louis, MO 63141-8266
Mailing address
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200
Other practice location 1
3000 Arlington Ave # MS 1137
Toledo, OH 43614-2598
Phone (419) 383-3514
Other practice location 2
100 Michigan St NE
Grand Rapids, MI 49503-2560
Phone (616) 364-4200
Other practice location 3
3333 Evergreen Dr NE
Grand Rapids, MI 49525-9493
Phone (616) 364-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4301506762 | Other | MI | MI BOARD OF MEDICINE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Wayne State University School of Medicine, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Michigan Ave NE
Grand Rapids, MI 49503-2560
100 Michigan St NE RM
280 Corewell Health Medical Group West
Grand Rapids, MI 49503-2560
Phone (616) 267-0115
15100 Whittaker Way
Grand Haven, MI 49417-8696
Phone (616) 772-4644
4444 Kalamazoo Ave SE
200 Corewell Health Medical Group West
Kentwood, MI 49508-4600
Phone (616) 391-5600
Hospital & facility affiliations
- Spectrum Health
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017022178 | MO | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum Health Primary Care Partners | Anesthesiology | Current | Accepting new patients |
| Spectrum Health Primary Care Partners | Orthopaedic Surgery | Current | Accepting new patients |
Locations
100 Michigan St NE
Grand Rapids, MI 49503
Phone (616) 391-1680
4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600
80 68th St SE
Kentwood, MI 49548
Phone (616) 391-8220
5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243
Interoperability endpoints
- amartin485195@epic00.corewelldirect.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1235188673
Orthopaedic Surgery
-
- Internal Medicine Physician
- Grand Rapids, MI
- NPI 1689499667
Anesthesiology
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Hastings, MI
- NPI 1932695525
-
- General Acute Care Hospital
- Grand Rapids, MI
- NPI 1922090554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662508800000",
"number": "1760903850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 EVERGREEN DR NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259493",
"telephone_number": "616-364-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "621 S NEW BALLAS RD STE 3005B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631418266",
"telephone_number": "314-251-7069"
}
],
"practiceLocations": [
{
"address_1": "3000 Arlington Ave # MS 1137",
"address_purpose": "LOCATION",
"city": "Toledo",
"state": "OH",
"postal_code": "436142598",
"country_code": "US",
"telephone_number": "419-383-3514",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 Michigan St NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495032560",
"country_code": "US",
"telephone_number": "616-364-4200",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3333 Evergreen Dr NE",
"address_purpose": "LOCATION",
"city": "Grand Rapids",
"state": "MI",
"postal_code": "495259493",
"country_code": "US",
"telephone_number": "616-364-4200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "ADAM",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-29",
"last_updated": "2022-09-07",
"certification_date": "2022-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "MO",
"license": "2017022178",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MI",
"license": "4301506762",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MI BOARD OF MEDICINE",
"identifier": "4301506762",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.